Gastrointestinal Endoscopy
Volume 78, Issue 3 , Pages 530-535, September 2013
Endoscopic sleeve gastroplasty: a potential endoscopic alternative to surgical sleeve gastrectomy for treatment of obesity
Barham K. Abu Dayyeh, MD, MPH, Elizabeth Rajan, MD, Christopher J. Gostout, MD
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
Received 14 January 2013; accepted 30 April 2013. published online 28 May 2013.

Obesity and its associated conditions, including type 2 diabetes and cardiovascular disease, have reached epidemic proportions. High-efficacy, high-risk surgical approaches are unlikely to meet the increasing burden of disease. Emerging endoscopic technologies have opened the door for endoscopic approaches to reproduce many of the benefits of GI weight loss surgery and thereby contribute to the effective treatment of obesity and its associated disorders.

Objective
To demonstrate the technical feasibility of transoral endoscopic gastric volume reduction with an endoscopic suturing device in a fashion similar to sleeve gastrectomy for the treatment of obesity.

Design
Single-center, pilot feasibility study.

Patients
Four human subjects with obesity.

Interventions
Transoral sleeve gastroplasty.

Main Outcome Measurements
Technical feasibility.

Results
We successfully used an endoscopic free-hand suturing system in 4 subjects, thus demonstrating the technical feasibility of a novel technique to mimic the anatomic manipulations created by surgical sleeve gastrectomy endoscopically.

Limitations
Pilot feasibility study with small number of subjects.

Conclusions
Endoscopic sleeve gastroplasty for treatment of obesity is feasible